Brave new world.
This was a study using AI (Yup. artificial intelligence) to look at people’s faces before and after facelift surgery to try to figure out which technique turns back the clock more.
This is out the of the September 2021 Aesthetic Surgery Journal. “Facelift Surgery Turns Back the Clock: Artificial Intelligence and Patient Satisfaction Quantitate Value of Procedure Type and Specific Techniques.”
Study: They wanted to try to make an objective evaluation to assess the different facelift techniques to see which is truly better. They used standardized pre and postop images at 1 year of patients who had facelifts with and without fat grafting. They looked at complications, estimated age reduction, and patient satisfaction. First they tested the “neural network age accuracy” pre surgery to show it was accurate in identifying the patient’s age.
Types of facelift studied:
- Skin only facelift
- SMAS plication (SMAS = superficial musculoaponeurotic system)
- SMAS removal (SMAS ectomy)
- With fat grafting
- Without fat grafting
Findings?
- The neural network age assessment was accurate pre surgery (This is AI thought to mirror the pattern of neurons in the brain analogous to the primary visual cortex)
- SMAS ectomy and SMAS plication had significantly greater age reduction than skin only. (5.85 and 5.35 vs. 2.95 years)
- Fat grafting gave 2.1 more years of age reduction
- Patients who had fat grafting had higher satisfaction (78 vs 69)
- Complication rates, OR time, and revisions were close in all groups.
My thoughts?
So exciting! Love that the computer can help give science to the questions of which techniques are better, instead of us looking at photos and trying to decide. The results didn’t surprise me- I do a SMAS facelift, as the SMAS is a deeper layer of fibrous tissue, and it helps lift the face and give longevity to the result. A skin only facelift is doomed to stretch right back out.
And the fat grafting giving more results and higher patient satisfaction? If you don’t know what a fan I am of fat grafting, you clearly haven’t been reading my website and blogs.
I found it interesting that AI thinks a facelift reversed the age for a patients by around 8 years on average (5.85 + 2.1 = 7.95 years) if you do SMAS and fat grafting. I also think it is interesting that age reversal of a skin only facelift was 2.95 years and fat grafting was 2.1 years. Does that mean fat grafting (no scars and much smaller surgery) is almost as good as a skin only facelift?
Interesting stuff.